breastfeeding

1. Enabling
Breastfeeding :
Making A
Difference For
Working Parents

2. Problems faced by working mothers :
•Lack of time to express breastmilk
•Lack of proper nursing facilities or resources
•Change in lifestyle
•Nipple confusion

3. UNICEF guidelines for children’s well-being, women’s
empowerment and the provision of decent work for caregivers:
• Sufficient paid leave to all parents and caregivers, in both the formal
and informal economies (this includes paid maternity, paternity, and
parental leave, and leave to care for sick young children).
• Support for mothers to breastfeed exclusively for the first six months
of life, as per World Health Organisation and UNICEF
recommendations, and to continue breastfeeding for as long as they
choose.
• Ensuring that all children have access to affordable, good quality
childcare and early education.

4. • Providing child benefits and adequate wages to help families provide
for young children.
• These policies provide parents and caregivers with the essential time,
resources and services needed to recover from giving birth and to
ensure secure bonding and attachment with their newborns, creating a
foundation for lifelong health.

5. Maternity Benefit Act ,1961
• She must have not worked less than 80 days in 12 months
• Paid maternity leave upto 26 weeks
• Leave prior to expected delivery date – 8 weeks
• A women having two or more living children shall only be entitled to
12 wks of maternity leave
• Establishment having > 50 employees mandatory to have a creche
facility , where women is allowed 4 visits /day
• Employer may allow women to work from home post the period of
maternity benefit .

6. Paternity leave
• A male employee with less than two children is
allowed to take paternity leave for 15 days, i.e. 15 days
before or up to 6 months from the birth of the child.

7. Benefits of supporting breastfeeding at work:
• is a low cost intervention for employers
• involves minimal disruption to the workplace
• brings benefits for employers including
• higher retention rates
• lower employee absenteeism rates on account of improved child
health
• lower health care costs
• enhanced employee morale and productivity and improved
company image

8. How to make the workplace breastfeeding-friendly
Several concrete options exist to make the workplace more
breastfeeding-friendly. They include the following:
Time: maternity leave, parental leaves, flexible hours, more breaks,
attention to parents needs regarding children’s schedules
Space: comfortable, private facilities for expressing breast milk, access
to a fridge to store milk, a clean and safe work environment, day care
facilities if feasible
Support: policy, information, discussions, consultations in support of
breastfeeding and of family-related entitlements

9. • Other elements can help to
support breastfeeding at work,
such as:
Proper information
Support from colleagues
Flexible working time
Childcare facilities
A breastfeeding policy

10. Breastfeeding Facilities :
• Breastfeeding facilities or nursing
rooms are simply a place where a
worker can feed her baby or express
her milk
• These facilities should be clean, have
clean water and privacy
• They are inexpensive to set up, and
can consist of only a conveniently
located small clean space with a chair,
access to clean water and a screen for
privacy
• More elaborate facilities can have a
refrigerator and an outlet for an
electric pump

11. Hirkani Kaksh :
• Hirkani’s Room has been
conceptualized in Maharashtra
(2007) as a facility at a workplace
Public place for lactating mothers
to express & store breastmilk.
• Hirkani’s room is a representation
of employer’s commitment to the
well-being of their employees in
general & lactating mothers in
particular. It shows that the
workplace is Mother & Baby
Friendly.

12. MILK EXPRESSION FOR
WORKING WOMEN

13. Before expression:
• Place a picture of your baby before you
• Use your baby’s blanket , clothing that has his or her scent on it
• Think of a relaxed setting
• Ensure a clean environment
• Wash your hands
• Apply a warm massage to the breast
• Remove milk during the times you would normally breastfeed your
baby.

14. Hand expression
• You use your hand to massage
and compress your breast to
remove milk
• Practice, Skill, Co-ordination
• No cost involved

15. Manual pump :
• You need your hand and wrist to
operate a hand held device to
pump the milk
• Practice, Skill, Co-ordination
• Cost – 300-500/-

16. Automatic Electric pumps :
• Runs on battery or plugs into an
electrical outlet
• Can pump one breast at a time or
both breasts at the same time
• Double pumping may collect
more milk in less time
• Cost – 5000- 10000/-

17. Storage :
• After pumping :
• Label the date on the storage container
• Gently swirl the container to mix the milk
• NO SHAKING
• Refrigeration or freezing :
• Leave an inch from the milk to the top of
the container
• Refrigerate or chill milk right after it is
expressed
• Store milk in the back of the freezer – not
in the freezer door
• Place it in a cooler or insulated cooler
pack

18. Storage Temperature (CDC) :
• Room temperature (25 C)
for up to 4 hours
• In main part of fridge (below
4C) up to 3-8 days
• Freezer (approx. -18 C) up
to 6-12 months
Freezer
Main Part

19. Thawing And Warming up milk :
• Use the oldest stored milk first
• Breast milk does not necessarily need to be warmed
• Place in the fridge to defrost slowly
• Place the container in a bowl of warm water
• Holding the container under running water
• No microwave
• Swirl the milk and test the temperature
• Do not re freeze

20. Breastfeeding in special conditions :
• Feeding during and after illness :Appropriate feeding during and after
illness is important to avoid weight loss and other nutrient deficiencies. The
cycle of infection and malnutrition can be broken if appropriate feeding of
infant is ensured. A breastfed baby should be given breastfeeding more
frequently during illness.
• Feeding in Mothers with HIV infection (NACO) :Exclusive breast feeding is
the recommended infant feeding choice for the first 6 months, irrespective of
whether mother or infant is provided with ARV drugs for the duration of breast
feeding. 3. Mixed feeding should not be practiced. Only in situations where breast
feeding cannot be done or on individual parents’ informed decision, replacement
feeding may be considered.

21. Feeding in mothers with Tuberculosis : (NTEP)
• Be assured that TB is not transmitted through breastmilk.Transmission
from mother to baby most commonly occurs after birth due to exposure to
TB bacteria in respiratory droplets, which are generated when a mother
with active lung TB talks, coughs, or sneezes.
• Only if a mother is noncompliant with her medications or is suffering
from multidrug-resistant TB, then she should not directly breastfeed or be
in direct contact with her baby until appropriate drug treatment is
administered and she is no longer infectious.
• Meanwhile her expressed breastmilk (EBM), collected with all hygienic
procedures including respiratory (wearing a mask) and hand hygiene
could be fed to the baby by cup or wati or katori and spoon by a
noninfected caretaker.

22. Babies with cleft lip :
• Babies born with just a cleft lip can usually
breastfeed well. The breast’s natural softness and
flexibility often allow it to conform to the shape
of the cleft .
• Point the cleft lip toward the top of the breast.
This gives you a good view of how well the breast
tissue is filling in the gap created by the cleft.
• Use your thumb or finger to plug the cleft during
breastfeeding. This can support the baby’s cheeks
and narrow the gap created by the cleft, which can
improve the seal on the nipple.

23. Babies with cleft lip and palate :
• Babies with cleft palate need to be fed expressed
(pumped) milk after each breastfeeding session.
That’s because a baby with cleft palate has
trouble creating enough suction during
breastfeeding . A baby with cleft palate may also
have sucking patterns (ways of moving the
mouth and jaw during feeding) that aren’t
efficient.
• Try positions that are comfortable for you and
that let your baby stay upright or semi-upright
during feedings(modified football hold).

24. • Support your baby’s chin and jaw with
your hand. The extra support can stabilize
the jaw and make sucking more efficient.
Use the “dancer hand” shape shown and
described at right.

25. HUMAN MILK BANKS
• All mothers should be encouraged to
breast-feed their infants. When a mother,
for some reason, is unable to feed her
infant directly, her breastmilk should be
expressed and fed to the infant. If
mother’s own milk is unavailable or
insufficient, the next best option is to use
pasteurized donor human milk (PDHM).
• One of the major reasons for loss of
interest in human milk banking was the
promotion of formula milk by the
industry.

26. LOCATION OF HUMAN MILK BANKS
• Human milk banks are primarily focused to provide donor
milk to high risk newborns admitted in the neonatal unit.
Therefore, a location in close proximity or even inside the
boundaries of neonatal unit is desirable. Postnatal wards or
Well Baby clinics of large hospitals are most suited for the
purpose as donors are likely to be found in large numbers
where medical and nursing staffs can encourage them to
donate milk.
• The only milk bank in East Vidarbha is in Daga Women's
Hospital , Nagpur.

27. •If PDHM supplies are sufficient donor milk may be
supplied for:
• Absent or insufficient lactation: Mothers with multiple births, who
can not secrete adequate breastmilk for their neonates initially.
• For babies of non-lactating mothers, who adopt neonates and if
induced lactation is not possible.
• Abandoned neonates and sick neonates.
• Temporary interruption of breastfeeding.
• Infant at health risk from breastmilk of the biological mother.
• Babies whose mother died in the immediate postpartum period.

28. CRITERIA FOR BREASTMILK DONORS
Who can donate?
A lactating woman who:
• is in good health, good health-related behavior, and not regularly on
medications or herbal supplements (with the exception of prenatal
vitamins, human insulin, thyroid replacement hormones, nasal sprays,
asthma inhalers, topical treatments, eye drops, progestin-only or low dose
estrogen birth control products);
• is willing to undergo blood testing for screening of infections; and
• has enough milk after feeding her baby satisfactorily and baby is thriving
nicely.

29. Who cannot donate?
uses illegal drugs,
tobacco nicotine
replacement therapy or
alcohol
HIV, HTLV,
Hepatitis B or C or
syphilis
received organ or
tissue transplant, any
blood
transfusion/blood
product
mastitis or fungal
infection , active
herpes simplex or
varicella zoster
infections

30. THANK YOU !